Bilingual Literacy and Reproductive Health, Bolivia

  • Date published:
    4 March 2016

Programme Overview

Programme Title Bilingual Literacy Project in Reproductive Health (Bi-Alfa Programme)
Implementing Organization Ministry of Education, Culture and Sport (MECD)
Language of Instruction Quechua and Spanish
Funding UNFPA, Turner Foundation
Programme Partners VEA (Vice Ministry of Alternative Education), Economic Commission for Latin America and the Caribbean (ECLAC/CEPAL) and the Demographic Centre for Latin America and the Caribbean (CELADE)
Date of Inception 1999

Context and Background

Bolivia is one of the poorest countries in Latin America. Wealth and socio-economic services are concentrated in urban areas, while about 90% of the rural population, most of whom are from indigenous populations, lives in extreme poverty, with limited access to basic services such as health and education. This has resulted in high levels of illiteracy and poor health standards in rural areas. For example, while the national illiteracy rate for women is 19%, it stands at around 40% in the department of Potosi where 90% of the population belongs to the indigenous population. Similar disparities exist with regard to reproductive health: while the average birth rate is 3.8%, it can be as high as 5.5% in the rural areas. In 2001, the maternal mortality rate in these rural locations was as high as 235 per 10,000 live births, and 62% of the deaths were of women with no access to professional reproductive health care services. Overall, these indicators reveal a strong correlation between a population’s standards of reproductive health (e.g. the use of contraceptives, the rate of maternal and infant mortality) and its level of education.

In this context and due also to the fact that 58% and 25% of Bolivia's population is under the age of 25 and of reproductive age (15–49 years), respectively, it was considered imperative to implement the Bilingual Literacy Project in Reproductive Health in order to address the inter-connected challenges of illiteracy and low reproductive health care awareness. The need for such a programme was even greater within the indigenous population due to the disparities between literacy rates and reproductive health standards detailed above.

Bilingual Literacy Project in Reproductive Health (Bi-Alfa Programme)

Since 1998, the Ministry of Education, Culture and Sport (MECD) has been working in partnership with the UNFPA to implement the Bilingual Literacy Project in Reproductive Health. The project was instituted in response to the high levels of illiteracy and high maternal and infant mortality rates among poor people, particularly those from the indigenous population. In light of this, the project endeavours to promote literacy skills development in order to improve people's living standards as well as reproductive health and child care practices. The project employs a gender-based approach and primarily targets women (85%). The project is aimed at people living in poor urban and rural areas, such as Chuquisaca, Potosí and Cochabamba, which have the highest concentration of indigenous peoples and high levels of illiteracy, as well as maternal and infant mortality. Furthermore, a multicultural approach is adopted to cater for the cultural and linguistic diversity of the participants.

The project is also being implemented in Paraguay, Mexico, Peru, Chile, Argentina and Guatemala with coordination and support from the Economic Commission for Latin America and the Caribbean (CEPAL/ ECLAC).


Aims and Objectives

The aims are to:

  • reduce illiteracy and maternal and infant mortality rates within the indigenous population;
  • improve living standards among the poor (poverty eradication);
  • promote the development of bilingual literacy skills within the indigenous population;
  • increase awareness of sexual and reproductive rights;
  • promote gender equality and multicultural awareness; and
  • improve women's participation in civic life and decision-making processes.

Programme Implementation: Approaches and Methodologies

The programme is based on the experiences learned from the pilot project in Peru, which focused on 100 indigenous women from poor communities. In 1999, the Bilingual Literacy Project in Reproductive Health was introduced in Bolivia by the UNFPA and the Ministry of Education. Since then, the programme has been funded by the Ministry of Education, local municipalities and NGOs in areas with high illiteracy and maternal mortality rates, such as Chuquisaca, Potosí and Cochabamba. UNFPA chose literacy training as means of improving participants’ reproductive health and encourages active social participation in the programme’s implementation.

Training of Trainers (ToT)

Programme facilitators of the Bi-Alfa Programme are mostly teachers in the formal education system but people with at least a secondary education and community leaders have also been engaged. All facilitators attend 16 to 20 days of formal training per year. The training curriculum includes literacy teaching methodologies, programme content and organization, management and evaluation of the learning process. The role of the facilitators is to moderate the learning process while encouraging the learners themselves to learn from each other through active engagement and participation in programme activities. Each facilitator is assigned about 20 learners in order to ensure effective learning.

Teaching/Learning Methods

The teaching methodology used by the programme is based on Paulo Freire’s principles and approaches to education, and thus emphasises the learners’ own life experiences and learning through critical, creative and active forms of teaching and learning. Accordingly, literacy training is conducted bilingually in order to encourage learners’ active participation in group activities, debates and discussions. Moreover, basic literacy courses are designed to be as relevant as possible to learners' lives. For example, the alphabet is introduced and taught using key and relevant thematic words such as health, pregnancy, children or gender relations. This method is designed to provoke and encourage critical thinking and debate.

Facilitators supplement these learner-centred methodologies with relevant visual aids (such as posters and videos) and practical activities (such as painting, group reading sessions, writing on the blackboard, cutting words out of newspapers and working with literacy manuals). An innovative strategy in this context is that most of the learning materials or aids are exclusively developed and produced by the indigenous communities and the learners themselves.

The programme is divided into basic and advanced levels. At both levels, learners attend two or three sessions per week (totalling 144 hours) over a period of six to eight months.

Thematic Focus

Literacy courses focus in particular on promoting: bilingual literacy, reproductive health, gender equality and multiculturalism.

  • Bilingual Literacy


Bolivia is a multicultural and multi-ethnic society. In order to promote and strengthen ethnic relations and cultural identity, the project employs a bilingual approach to literacy training. Hence, learning is conducted in both indigenous languages and in Spanish. The bilingual approach is vital because it not only helps learners to comprehend the issues covered, but also draws on the learners' experiences and cultural sensitivities.

  • Sexual and Reproductive Health

The gender perspective – a dimension that is neglected by many literacy projects – is central to the Bilingual Literacy Project in Reproductive Health. As highlighted above, the high levels of illiteracy among indigenous women means that they need special assistance in matters relating to reproductive health, and this can only be achieved by developing their literacy skills. The project therefore endeavours to increase learners' knowledge and awareness of women’s reproductive health rights and needs in order to empower them to lead healthy lives and make use of the appropriate primary reproductive medical services. This is ultimately intended to reduce the incidence of maternal and infant mortality.

Furthermore, the literacy courses harness the gender perspective in order to hold open discussions on topics such as self-esteem, self-care, violence-free relationships, the empowerment of women, parental roles in the education of children, and decision-making and negotiations within families. The integration of gender-specific topics is intended to promote gender rights awareness, equality and respect. This is particularly important for women given their culturally-designated subservient social position both within the family and in the community as a whole.

However, because the idea of equal rights and opportunities for women defies entrenched traditional value systems, the programme not only encourages mixed groups of women and men to discuss these issues but also employs a community-based learning system and sensitisation activities that involve the entire community.

  • Multiculturalism

The programme employs a multicultural approach that reflects the cultural diversity of its learners, particularly with regard to history, language, cosmology, beliefs, forms of production and social structures. Multiculturalism is understood to imply a horizontal examination and mutual recognition of cultural differences, and learners are encouraged to reflect on their own and others’ culture and cultural identity in order to recognise these differences and learn from them. A multicultural approach also involves integrating indigenous knowledge systems into the learning process, and thus strengthening ethno-cultural identities rather than imposing specific worldviews or practices and acting in a protectionist attitude towards cultural traditions. Ultimately, the project aims to empower indigenous people to become full, active and respected members of national society.

Advanced Literacy Training

At the end of the basic literacy level, the programme offers learners the opportunity of starting advanced literacy skills training. The advanced level draws on both scientific and traditional systems of medicine to extend learners’ knowledge of health-related topics, such as community health and hygiene, healthy living (nutrition), family planning, childbirth and postnatal health, child care, and sexually transmitted diseases. The programme also promotes the development of skills for the purposes of income generation.

Programme Impact and Challenges

Monitoring and Evaluation

The project uses a system of ongoing evaluation in which facilitators undertake assessments. Professional external evaluators are also engaged to carry out a quantitative and qualitative evaluation of the programme’s impact on participants and their communities.


  • Enrolment: 1,610,091 learners enrolled in the programme between 1998 and 2007, of whom 112,241 completed the first level (88,624 women) and acquired functional bilingual literacy skills. 24,527 enrolled in and completed the second level, of whom 19,515 were women and 5,012 were men. During the last year, 375 learners enrolled in the third level of the programme (213 women and 162 men). Overall, between 78% and 86% of learners have become functionally literate.
  • Training of trainers: During nine years of implementation, the programme has trained 390 pedagogical coordinators and 5,468 facilitators.
  • Health and gender issues: The integration of health and gender-related topics into the literacy programme has empowered indigenous communities and improved women’s awareness of family planning and women’s reproductive health care needs. As a result, many rural women are now seeking primary health care services, including screening for cervical and breast cancer. Improvements in primary health care have led to a decline in maternal and infant mortality rates in rural areas.
  • Sensitive issues: The open discussion of culturally-sensitive topics such as family violence and women’s rights has lead to a decline in violence against women and an improved awareness of women’s fundamental rights.
  • Emancipation: Women are increasingly participating in civic life due to the liberating effect of education.
  • Poverty eradication: Programme participants have been empowered to engage in income generating activities.
  • Parental support: Because parents from indigenous communities have developed a greater interest in education, many children in the formal school system are now receiving support from their parents.



The following are some of the key challenges that the programme faces:

  • The government has generally shown little interest in supporting or prioritising literacy programmes. As a result, adult education programmes have not been integrated into the country’s educational policies and programmes. Furthermore, bilingual literacy training is not sufficiently integrated into the teacher training system for the non-formal education sector. This lack of governmental support has been a barrier to the full implementation of the programme.
  • In addition to limited governmental support, the lack of adequate funding for resources, project facilitators and pedagogical coordinators has also hindered the institutionalisation of the programme.
  • Poor infrastructures create major difficulties for rural learners who are forced to commute long distances to reach the nearest learning centre. This has often forced rural-based learners to drop out and deters prospective learners from enrolling.
  • The rate of enrolment often decreases during the peak agricultural seasons when most rural learners concentrate on their farms.
  • Traditional gender roles further limit women's participation in the programme. For example, female learners with children have often found it difficult to care for their children and simultaneously participate in learning activities. Furthermore, traditional value systems work against the full implementation of the programme because they restrict the openly discussion of issues related to reproductive health.


Lessons Learned

The following are the key lessons that have emerged from the programme:

  • The contents and methodologies of an adult literacy programmes must be contextualised and based on the specific situation, needs and interests of the learners. Moreover, to promote gender equality, human rights, and intercultural learning, the cultural background of the learners should be integrated into the programme. This cannot be done “from above”; instead, the programme must be designed for and together with the learners themselves, and it must respect and promote local knowledge.
  • Literacy training should be adapted to the participants’ agricultural calendar, and more courses should be scheduled during the off-peak season.
  • The programme has demonstrated how important it is for different stakeholders to cooperate at all levels of the project. Despite the fact that the programme received insufficient funding from the national government, partnerships established with the municipal and local governments have helped to sustain it.
  • Similarly, partnerships with indigenous organizations are an equally important means of raising awareness and generating positive publicity among potential learners. Hence, sensitisation and public awareness campaigns are critical to securing much-needed support for the institutionalisation of the programme.
  • The programme serves as a good model for adult literacy campaigns. It fights discrimination against indigenous languages, strengthens the cultural identity of indigenous people, and opens up possibilities for lifelong learning.
  • The programme’s success shows that it is possible to learn two written languages simultaneously, while at the same time addressing the culturally sensitive issues of gender equality, reproductive health and multiculturalism.



Monica Yaksic Prudencio
Avenida del Maestro N° 345
Edificio SEDUCA 1er. Piso
Sucre – Bolivia
E-mail: yaksic (at) unfpa.org.bo
Tel. +591 46 45 61 66

Rolando Encinas Caballero
Maria Martinez Mita
Email: mmartinez_mita (at) yahoo.com / bialfa (at) entelnet.bo

Last update: 15 January 2010

For citation please use

U. Hanemann (Ed.). Last update: 18 July 2017. Bilingual Literacy and Reproductive Health, Bolivia. UNESCO Institute for Lifelong Learning. (Accessed on: 26 September 2023, 00:35 CEST)

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